Effectiveness of Decentralisation by Devolution Approaches in Public healthcare services Delivery in Ilala Municipal Council and Geita Town Council, Tanzania

This study investigates the effectiveness of Decentralisation by Devolution (D-by-D) in public healthcare service delivery within Ilala Municipal Council and Geita Town Council, Tanzania. Employing a mixed-methods approach, including quantitative surveys and qualitative interviews with local key in...

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Main Authors: Africanus Calist Sarwatt, Omary Magasha Yusuf, Adam Matiko Charles
Format: Article
Language:English
Published: Utafiti Foundation 2025-01-01
Series:Eastern African Journal of Humanities and Social Sciences
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Online Access:https://utafitionline.com/index.php/eajhss/article/view/904
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author Africanus Calist Sarwatt
Omary Magasha Yusuf
Adam Matiko Charles
author_facet Africanus Calist Sarwatt
Omary Magasha Yusuf
Adam Matiko Charles
author_sort Africanus Calist Sarwatt
collection DOAJ
description This study investigates the effectiveness of Decentralisation by Devolution (D-by-D) in public healthcare service delivery within Ilala Municipal Council and Geita Town Council, Tanzania. Employing a mixed-methods approach, including quantitative surveys and qualitative interviews with local key informants, the research reveals critical insights into how D-by-D frameworks impact healthcare quality and accessibility. Findings indicate that while some approaches, such as project monitoring and budget allocation, are perceived as effective, others—particularly multi-stakeholder involvement, participation, and strategic planning—are regarded as ineffective. The average effectiveness score across both councils suggests a moderate perception of D-by-D functioning, yet significant gaps exist regarding community engagement, resource allocation, and local governance capabilities. Challenges include inadequate funding, personnel shortages, and a lack of transparency, which hinder the realization of Decentralisation’s intended benefits. The study underscores a prevalent sense of skepticism regarding healthcare quality in both councils and highlights the necessity for reforms to better align local health priorities with community needs. To enhance the effectiveness of D-by-D, the research recommends strengthening financial support to Local Government Authorities, enhancing human resource capacity, fostering community participation, and promoting accountability and transparency in healthcare governance. This research contributes to the understanding of local governance in Tanzania and offers essential insights for policymakers aiming to improve healthcare outcomes through decentralized frameworks.
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spelling doaj-art-110f7cf776ff4108b55cf922da5008d82025-08-20T02:39:28ZengUtafiti FoundationEastern African Journal of Humanities and Social Sciences2958-45582025-01-014110.58721/eajhss.v4i1.904Effectiveness of Decentralisation by Devolution Approaches in Public healthcare services Delivery in Ilala Municipal Council and Geita Town Council, TanzaniaAfricanus Calist Sarwatt0Omary Magasha Yusuf1Adam Matiko Charles2Institute of Rural Development Planning, TanzaniaInstitute of Rural Development Planning, TanzaniaThe Mwalimu Nyerere Memorial Academy, Tanzania This study investigates the effectiveness of Decentralisation by Devolution (D-by-D) in public healthcare service delivery within Ilala Municipal Council and Geita Town Council, Tanzania. Employing a mixed-methods approach, including quantitative surveys and qualitative interviews with local key informants, the research reveals critical insights into how D-by-D frameworks impact healthcare quality and accessibility. Findings indicate that while some approaches, such as project monitoring and budget allocation, are perceived as effective, others—particularly multi-stakeholder involvement, participation, and strategic planning—are regarded as ineffective. The average effectiveness score across both councils suggests a moderate perception of D-by-D functioning, yet significant gaps exist regarding community engagement, resource allocation, and local governance capabilities. Challenges include inadequate funding, personnel shortages, and a lack of transparency, which hinder the realization of Decentralisation’s intended benefits. The study underscores a prevalent sense of skepticism regarding healthcare quality in both councils and highlights the necessity for reforms to better align local health priorities with community needs. To enhance the effectiveness of D-by-D, the research recommends strengthening financial support to Local Government Authorities, enhancing human resource capacity, fostering community participation, and promoting accountability and transparency in healthcare governance. This research contributes to the understanding of local governance in Tanzania and offers essential insights for policymakers aiming to improve healthcare outcomes through decentralized frameworks. https://utafitionline.com/index.php/eajhss/article/view/904DecentralisationDevolutionHealthcareIlalaLocal governance
spellingShingle Africanus Calist Sarwatt
Omary Magasha Yusuf
Adam Matiko Charles
Effectiveness of Decentralisation by Devolution Approaches in Public healthcare services Delivery in Ilala Municipal Council and Geita Town Council, Tanzania
Eastern African Journal of Humanities and Social Sciences
Decentralisation
Devolution
Healthcare
Ilala
Local governance
title Effectiveness of Decentralisation by Devolution Approaches in Public healthcare services Delivery in Ilala Municipal Council and Geita Town Council, Tanzania
title_full Effectiveness of Decentralisation by Devolution Approaches in Public healthcare services Delivery in Ilala Municipal Council and Geita Town Council, Tanzania
title_fullStr Effectiveness of Decentralisation by Devolution Approaches in Public healthcare services Delivery in Ilala Municipal Council and Geita Town Council, Tanzania
title_full_unstemmed Effectiveness of Decentralisation by Devolution Approaches in Public healthcare services Delivery in Ilala Municipal Council and Geita Town Council, Tanzania
title_short Effectiveness of Decentralisation by Devolution Approaches in Public healthcare services Delivery in Ilala Municipal Council and Geita Town Council, Tanzania
title_sort effectiveness of decentralisation by devolution approaches in public healthcare services delivery in ilala municipal council and geita town council tanzania
topic Decentralisation
Devolution
Healthcare
Ilala
Local governance
url https://utafitionline.com/index.php/eajhss/article/view/904
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AT omarymagashayusuf effectivenessofdecentralisationbydevolutionapproachesinpublichealthcareservicesdeliveryinilalamunicipalcouncilandgeitatowncounciltanzania
AT adammatikocharles effectivenessofdecentralisationbydevolutionapproachesinpublichealthcareservicesdeliveryinilalamunicipalcouncilandgeitatowncounciltanzania